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Background: COVID-19 or coronavirus disease is caused by SARS-CoV2 and has affected a large population globally including India. It has affected subjects from all age groups including children. However, despite intensive research conducted on COVID-19, data is scarce concerning the epidemiological and clinical features and transmission pattern of COVID-19 in child subjects of India. Aim: The present study aimed to assess the clinical features and epidemiological profile of Indian pediatric subjects during the COVID-19 pandemic. Methods: The study assessed 100 child subjects within the age range of 1 month to 18 years with the confirmed diagnosis of COVID-19 using the nasopharyngeal swab and tested with RT-PCR (reverse transcriptase-polymerase chain reaction). In these subjects, laboratory profiles and clinical parameters were assessed and collected data were statistically analyzed. Results: The most common symptom was fever in 34% (n=34) study subjects followed by cough in 16% (n=16) child subjects, sore throat in 135 (n=13) study subjects, malaria in 7% (n=7) children, and diarrhea and headache in 5% (n=5) children each. The severity of illness was mild, moderate, and severe in 35 9n=3), 39% (n=39), and 58% (n=58) children. Conclusion: The present study, considering its limitations, concludes that the burden of COVID-19 disease is higher in child subjects from a low socioeconomic status with a history of positive contact from the household. COVID-19 has also been shown to have a mild pattern in subjects from the pediatric age group. The LMR (lymphocyte monocyte ratio) showed a significant association with the disease severity with p=0.02 and NLR (neutrophil-lymphocyte ratio) also had a significant correlation with COVID-19 severity with p=0.01. However, no significant correlation to disease severity was seen for CRP levels and PLR (platelet lymphocyte ratio) with p=0.06 and 0.26 respectively. [ABSTRACT FROM AUTHOR]

Background: COVID-19 or coronavirus disease is caused by SARS-CoV2 and has affected a large population globally including India. It has affected subjects from all age groups including children. However, despite intensive research conducted on COVID-19, data is scarce concerning the epidemiological and clinical features and transmission pattern of COVID-19 in child subjects of India. Aim: The present study aimed to assess the clinical features and epidemiological profile of Indian pediatric subjects during the COVID-19 pandemic. Methods: The study assessed 100 child subjects within the age range of 1 month to 18 years with the confirmed diagnosis of COVID-19 using the nasopharyngeal swab and tested with RT-PCR (reverse transcriptase-polymerase chain reaction). In these subjects, laboratory profiles and clinical parameters were assessed and collected data were statistically analyzed. Results: The most common symptom was fever in 34% (n=34) study subjects followed by cough in 16% (n=16) child subjects, sore throat in 135 (n=13) study subjects, malaria in 7% (n=7) children, and diarrhea and headache in 5% (n=5) children each. The severity of illness was mild, moderate, and severe in 35 9n=3), 39% (n=39), and 58% (n=58) children. Conclusion: The present study, considering its limitations, concludes that the burden of COVID-19 disease is higher in child subjects from a low socioeconomic status with a history of positive contact from the household. COVID-19 has also been shown to have a mild pattern in subjects from the pediatric age group. The LMR (lymphocyte monocyte ratio) showed a significant association with the disease severity with p=0.02 and NLR (neutrophil-lymphocyte ratio) also had a significant correlation with COVID-19 severity with p=0.01. However, no significant correlation to disease severity was seen for CRP levels and PLR (platelet lymphocyte ratio) with p=0.06 and 0.26 respectively. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-causing COVID-19 resulted in mortality, and the clinic-epidemiological profile at the time of admission of patients who died later could provide an insight into pathophysiological consequences due to infection. Method: Retrospective observational study of 64 RTPCR-confirmed COVID-19 non-survivors was conducted from April - June 2021 and January February 2022. Data were analyzed, and a P value<0.05 was taken as significant. Results: 60.94% and 39.06 % were males and females, and 26.57% & 73.43 % of patients had moderate and severe disease, respectively. Fever, cough, and dyspnea were the most common presenting symptoms. 78.12% and 21.88% had pre-existing (diabetes and hypertension were most common) and no co-morbidities, respectively. 65.62 & 17.19 % of patients had bilateral and unilateral ground glass opacities, respectively. Thrombocytopenia, lymphopenia, neutrophilia, elevated monocytes, and neutrophil-lymphocyte ratio (NLR) of 7.52 were hematological findings. D dimer was elevated. ABG showed low PaO2 and SPO2 %. ALT and AST were elevated. Tachycardia was also present. Compared to the first wave, no significant association of gender with severity was found. However, the percentage of male patients was higher. The association of the duration of stay and co-morbidity with disease severity was significant in both the first and subsequent waves of COVID-19. Conclusion: Co-morbidity, disease severity, and radiological lung opacities play a role in the outcome of COVID-19. The associated findings are hematological, renal, liver, cardiovascular, and arterial blood gas derangements. [ABSTRACT FROM AUTHOR]

Introduction: There has been adequate evidence that children are less likely to contract the Coronavirus Disease-2019 (COVID-19) infection and less likely to experience a deadly course of the disease in the paediatric group. The majority of the time, they exhibit moderate respiratory symptoms, like fever, dry cough and exhaustion. They were all free of COVID-19 pneumonia. Aim: To compare the clinical features and short-term outcomes of COVID-19 in children during May 2020 to April 2022. Materials and Methods: The present analytical observational study was conducted in the Department of Paediatrics, Chettinad Hospital, Chennai, Tamil Nadu, India, from March 2020 to March 2022. The study population included Reverse Transcription-Polymerase Chain Reaction (RT-PCR) positive COVID-19 children between age groups of one month and 18 years age. A sample size of 102, 90 and 98 were included from first, second and third wave, respectively. Kruskal-Wallis test and Analysis of Variance (ANOVA) test were used were used for statistical analysis. Results: In the study population, the mean age in the wave 1, wave 2 and wave 3 was 9.1±5.25 years, 9.3±4.99 years and 9.2±5.12 years, respectively. Males were more affected in all the phases than females. The most common symptoms in all the three waves were cough, myalgia and fever. Fever was the predominant symptom reported in all three waves (74.8% in wave 1, 80.6% in wave 2 and 75% in wave 3). Between the COVID-19 waves, baseline investigations such as Alanine Transaminase (ALT) and Aspartate Transaminase (AST) (p-value=0.001, 0.02) showed significant differences. C-reactive Protein (CRP) was non reactive in (81.55%) in wave 1, (85.07%) in wave 2 and (65.3%) in wave 3. (p-value=0.029). Conclusion: The present study results conclude that the presenting features of COVID-19 in children were mild, and the outcome was good. The first, second and third waves had considerable differences in clinical findings and short-term outcomes among COVID-19-affected children. [ABSTRACT FROM AUTHOR]

Coronavirus disease is an infectious disease caused by severe acute respiratory syndrome-coronavirus 2 virus. It predominantly affects respiratory system causing fever, cough, and breathlessness. But it can also affect central nervous system and peripheral nervous system. It is important that physicians keep a high index of suspicion for patients with neurologic symptoms following a recent or during COVID-19 infection. The low rate of initial diagnosis is alarming, as few of the percentage of patients with Guillain-Barre syndrome will develop respiratory muscle weakness requiring invasive ventilation. The ability to recognize the disease process could lead to life saving management. Furthermore, the initiation of therapy such as plasma exchange or intravenous immunoglobulin leads to an accelerated recovery time. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) infection in India demonstrated three peaks in India, with differences in presentation and outcome in all the three waves. The aim of the paper was to assess differences in the epidemiological, clinical features and outcomes of patients with COVID-19 presenting at a tertiary care hospital in the three waves at Jaipur, India. Methods: This was a retrospective study conducted at a tertiary care hospital at Jaipur, India. Demographic, clinical features and outcomes were compared of confirmed COVID-19 cases admitted during the first wave (16-7-2020 to 31-1-2021), second wave (16-3-2021 to 6-5-2021) and third wave (1-1-22 to 20-2-22) of the outbreak. Results: There were 1006 cases, 639 cases and 125 cases admitted during the three waves, respectively. The cases presenting in the second wave were significantly younger, with significantly higher prevalence of symptoms such as fever, cough, sore throat, nausea, vomiting, headache, muscle ache, loss of appetite and fatigue (P < 0.05). A significantly higher proportion of patients received Remdesivir in the second wave (P < 0.001). However, in the second wave, the use of low molecular weight heparin, plasma therapy, non-invasive and invasive ventilator were higher (P < 0.001). Co-morbid conditions were significantly higher in the admitted patients during the third wave (P < 0.05). Radiological scores were similar in second and third wave, significantly higher than the first wave. Lymphopenia and rise of inflammatory markers including C-reactive protein and interleukin-6 were more evident in the second wave (P < 0.001). The mean mortality, hospital stay and air-leak complications were also significantly higher in the second wave (P < 0.001). Conclusions: The second wave was more vicious in terms of symptoms, inflammatory markers, radiology, complications, requirement of ventilation and mortality. Mutation in the virus, lack of immunity and vaccination at the time point of second wave could have been the possible causes. The ferocity of the second wave has important implications for the government to formulate task forces for effective management of such pandemics. [ABSTRACT FROM AUTHOR]

Introduction: Ahmedabad city reported the highest number of cases and deaths. In order to guide various interventions and monitor future trends, evidence is required. Hence, we conducted the present study to explore the epidemiological determinants, clinical profile, risk factors, and predictors of mortality of COVID-19. Methods: This was a retrospective record-based descriptive study of 2268 confirmed COVID-19 patients admitted in a designated COVID hospital of Ahmedabad city from March to July 2020. Results: The median age of patients was 54 years, and 60.9% of them were males. Majority (83.27%) had comorbidities; the most common comorbidity was hypertension (62.59%) followed by diabetes (44.76%). The most common symptoms reported were fever (69.76%), breathlessness (55.47%), and cough (53.18%). Majority (61.12%) of the patients showed lymphocytopenia, and in one-third (34.85%), D-dimer levels were elevated (>1 μg/ml). Odds of inhospital deaths were higher in patients having breathlessness and gastrointestinal symptoms and comorbidities. More of the deceased had leukocytosis and lymphocytopenia, high D-dimer levels, C-reactive protein, and altered liver function tests as compared to the survivors. Conclusion: While making decisions such as prevention of exposure of high-risk population to the infection, control of the existing comorbid condition, and prioritization of this population for vaccination, criteria of case definition for surveillance keeping in mind the typical and atypical manifestations of the disease, require robust evidence which the current study could provide insight to. [ABSTRACT FROM AUTHOR]

Introduction: Several months into the coronavirus disease 2019 (COVID-19) pandemic, there remains a paucity of data on the behavior of the disease in patients with end-stage kidney disease (ESKD) on maintenance hemodialysis (MHD). Here, we describe the clinical presentations, biochemical profile, and outcomes of 183 such patients from a large tertiary-care center in South India. Materials and Methods: This prospective, observational study, included all patients with COVID-19 and ESKD who received at least one session of hemodialysis at our center, from the start of the outbreak to July 9, 2020. Clinical features at presentation, laboratory and radiological data, and outcomes were analyzed. Results: A total of 183 patients were included in the analysis. Patients who had symptoms at presentation accounted for 49.18% of the cohort, with the most common symptoms being fever (87.1%), cough (67.7%), and breathlessness (63.4%). Factors independently associated with mortality on univariate analysis included age ≥60 years, having symptoms at presentation, neutrophil--lymphocyte ratio >6, C-reactive protein >20 mg/L, serum lactate dehydrogenase >250 IU/L, CT (computed tomography) Grades 3 and 4, and the need for respiratory support. However, on multivariate logistic regression analysis, the only factor that retained significance was an age >60 years. Conclusions: This analysis confirms the previous reports of higher COVID-19-related mortality in the dialysis population and identifies older age, higher inflammatory markers, and greater degrees of radiological lung involvement to correlate with increased mortality. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic affected millions of people across India. COVID-19 cases are fewer in children with less severity and better outcomes than in adults. However, a small proportion develop severe illness and succumb to the disease. Clinical manifestations and optimal management of COVID-19 in immunocompromised children are not clearly known. Remdesivir was shown to be efficient in reducing the recovery time in COVID-19 patients requiring supplemental oxygen. Remdesivir is approved for use in children with severe COVID-19, but there are no guidelines in patients with risk factors like recent solid organ transplantation. We report a case of a 10-year-old kidney transplant recipient (KTR) infected with severe acute respiratory syndrome corona virus-2, 2.5 months after the transplantation. Unlike most children, he presented with high fever, cough, and vomiting. His inflammatory markers were elevated. In this case report, we discussed management and clinical outcomes of this patient. In view of recent kidney transplantation and the severity of infection with emergent oxygen requirement, we gave him remdesivir. We continued prednisolone and tacrolimus and stopped mycophenolate. He recovered completely in 7 days. We feel that severely immunosuppressed KTR children with COVID-19 will benefit with remdesivir administration. Monitoring tacrolimus trough levels is essential for maintaining adequate immunosuppression. [ABSTRACT FROM AUTHOR]

A 43‑year‑old‑married male diagnosed with coronavirus disease 2019 (COVID‑19) in July 2020. His symptoms as described by him began with cough and sore throat, breathlessness, generalized body weakness, irritability, stress, and mood swing for a period of one week. He was admitted in our District COVID Care Center (DCCC) located in Tamil Nadu, India. He underwent Integrated Yoga and Naturopathy (IYN) [i.e., Conventional medicine + yoga and naturopathy] for two weeks. The results showed negative Reverse Transcription Polymerase Chain Reaction (RT–PCR) test for COVID‑19, improvement in cardiovascular functions (i.e., a reduction in systolic and diastolic blood pressures, pulse rate, mean arterial pressure, rate pressure product, and double product) and mental health (i.e., a reduction in depression, anxiety, and stress levels). The results suggest that IYN might improve cardiovascular and mental health of patients with COVID‑19 in addition to positive to negative conversion of RT–PCR. However, further studies are required to warrant these results. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic emerged as a major public health emergency affecting healthcare services all over the world. It is essential to analyze the epidemiological and clinical characteristics of patients with COVID-19 in different parts of our country. This study highlights clinical experience in managing patients with COVID-19 at a tertiary care center in South India. It is pertinent to identify the clinical and demographic characteristics of patients considering the novelty and substantial heterogeneity of the illness across the world. The pathogen has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has a phylogenetic similarity to SARS-CoV beta coronavirus. Aim of the study: To assess the demographics, clinical characteristics, comorbidities, and outcomes of a cohort of patients with COVID-19. Materials and methods: A record-based cross-sectional study. All cases were admitted in the covid ward of the Department of TB & Respiratory Disease, Government Hospital of Thoracic Medicine, Chennai from 26th June to 5th December 2020. A total of 2552 patients with confirmed covid-19 were included in the study. All the patients were analyzed in study demographics, clinical characteristics, comorbidities, and outcomes of a cohort of patients with COVID-19. Results: 24 patients were excluded due to a lack of sufficient data. Of the remaining 976 in the early phase of the epidemic, males were admitted twice as much as females (67.1% and 32.9%, respectively). More than 8% reported no symptoms and the most common presenting symptoms were fever (78.3%), productive cough (37.2%), and dyspnea (30.64%). More than one-half (53.6%) had no co-morbidity. The major comorbidities were hypertension (23.7%), diabetes without (15.4%), and complications. Conclusion: The majority of the patients with COVID-19 infection presenting to our hospital were young and asymptomatic. Fever was noted only in three-fourth of the patients and respiratory symptoms in half of them. Patients with comorbidities were more vulnerable to complications. Triaged classification of patients and protocol-based treatment resulted in good outcomes and low case fatality. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic has severely affected sports worldwide. Usual practice can’t be done due to high viral transmission, yet prolonged inactivity leads to detraining and deconditioning and threatens ending of sporting career. Depending on the present guidelines of the government, a safe and evidence based gradual resumption of training and sports is essential. The cardiorespiratoryneuromuscular system involvement among others in COVID-19 directly affects exercise-sports performance and health, and the possibility of sub-clinical transmission poses immense challenge. Like other games, swimming is also heavily affected. Although COVID-19 is transmitted by droplets, the prolonged presence of virus in the air currents, commonly-touched surfaces and in stool of those infected should be kept in mind. Importance of hand hygiene, cough and sneeze etiquette, social distancing, use of mask while not exercising hard, other good public hygiene practices, staying home if sick, frequent cleaning and disinfection of pool and frequently touched surfaces, early detection, isolation and adequate treatment for the positive cases and strictly following government guideline should be compulsory. Awareness program and continued education for athletes, parents, coaches, support staff and other management team should be done. This review is intended to understand the course of COVID-19 and to formulate guidelines for resumption of swimming in India, based on recommendations by various organisations like WHO, CDC etc. The aim being to act as a key support for safely resuming swimming yet reducing the risk of COVID-19 infection. [ABSTRACT FROM AUTHOR]

Coronavirus disease (COVID-19) is an inflammation disease from a new virus. The disease causes respiratory ailment (like influenza) with manifestations, for example, cold, cough and fever, and in progressively serious cases, the problem in breathing. COVID-2019 has been perceived as a worldwide pandemic and a few examinations are being led utilizing different numerical models to anticipate the likely advancement of this pestilence. These numerical models dependent on different factors and investigations are dependent upon potential inclination. Here, we presented a model that could be useful to predict the spread of COVID-2019. We have performed linear regression, Multilayer perceptron and Vector autoregression method for desire on the COVID-19 Kaggle data to anticipate the epidemiological example of the ailment and pace of COVID-2019 cases in India. Anticipated the potential patterns of COVID-19 effects in India dependent on data gathered from Kaggle. With the common data about confirmed, death and recovered cases across India for over the time length helps in anticipating and estimating the not so distant future. For extra assessment or future perspective, case definition and data combination must be kept up persistently. [ABSTRACT FROM AUTHOR]